[Ultrasound diagnosis of fetal inflammatory response syndrome in women with preterm premature rupture of membrane]

Abstract

Objective: The aim of this review is to analyze the existing possibilities of using ultrasound in the diagnosis of the fetal inflammatory response.

Design: Review.

Settings: Gynekologicko-porodnická klinika, Fakultní nemocnice Ostrava.

Methods: Preterm delivery is defined as a delivery before completed 37 weeks of gestation. Approximately one-thirdof these cases is associated with preterm premature rupture of membranes. About forty percent of preterm premature rupture of membranes is complicated by the fetal inflammatory response syndrome, which is associated with the development of severe perinatal morbidity. Recent prenatal diagnosis of the fetal inflammatory response syndrome is based on the invasive methods (amniocentesis, cordocentesis), which are limited by several risk factors accompanying these procedures and technical difficulties. Therefore, there is an effort to replace them by non-invasive approach. The development of ultrasound, as a diagnostic method through the last decade, and knowledge of pathophysiological and morphological changes in fetal organs associated with the fetal inflammatory response may lead to more specific diagnosis in the future and improvement of neonatal outcome.

Conclusion: Early identification of fetuses affected by FIRS in pregnancies with PPROM is necessary for right management of these pregnancy pathology. At this moment, ultrasonography examination of fetal lineal vein and fetal echocardiography, seems to be suitable for diagnosing FIRS.

Keywords: adrenal glands; amniotic fluid; heart; interleukin-6; kidney; preterm delivery; spleen thymus..